Functional Movement LLC

NPI #1083256747 in Ponte Vedra Beach, Florida

Provider Information

NPI Number: 1083256747
Entity Type: Organization
Organization Name: Functional Movement LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Oct 15, 2019
Last Updated: Oct 15, 2019

Practice Location

Address: 124 STADIUM CT
City: Ponte Vedra Beach
State: Florida
ZIP Code: 32082-3152
Phone: (757) 651-0183

Authorized Official

Name: KRISTEN GALLOWAY, OTR/L
Title: OWNER
Phone: (757) 651-0183

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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